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WELL LIFE FAMILY MEDICINE INC NPI 1063903748


NPI Information

NPI: 1063903748
Provider Name: WELL LIFE FAMILY MEDICINE INC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 04D2150344

Address:
1623 ROGERS AVE
FORT SMITH, AR
ZIP 72901
Phone: (479) 782-6318
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WELL LIFE FAMILY MEDICINE INC is a general practice in Fort Smith, AR. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee WELL LIFE FAMILY MEDICINE INC NPI is 1063903748. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1623 ROGERS AVE
FORT SMITH, AR
ZIP 72901-826
Phone: (479) 782-6318
Fax: (479) 782-7028

The provider's authorized official is Bryan K Ledbetter .
The authorized official title is D.o./ Owner and has the following contact phone number (479) 782-6318.

The CLIA number assigned to this NPI record is 04D2150344 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/29/2018 and was last updated on 5/29/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeT2018-104ARKANSASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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